Diabetes Management and Health Status in a Community Context - Term Paper Example

Introduction Diabetes is a significant problem greatly affects Aboriginal. Appropriate management can delay the process of the disease and prevent severe complications. The target populations in this essay are Rural Indigenous elders, who posses’ most vulnerable circumstances regard to diabetes management (PriceWaterhouseCoopers, 2001). This essay will describe rural indigenous elders and identify how these factors negatively impact their diabetes management. Definition of the concept of health literacy and its components will be done which will then be followed by an exploration of how health literacy has been poor access to services, gaps in social policies, socialecnomical disadvantages, and cultural related factors which ultimately influence diabetes management in this particular group. The essay will go ahead and demonstrate how community nurses use an empowerment approach based on the principles of primary health care and health promotion to promote health literacy, in order to help them to improve their health literacy level, gain insight of the determinants of health. As well as increase their ability and willingness to access health services by encourage their self motivations, by collaborate with other interagency alliances, advocate for policies change and with the participation of Indigenous people. Therefore to ultimate improve diabetes management and health status in a community context. Main body Aboriginal people face significant health disadvantage due to living in remote, being Indigenous and being elders. These populations are more vulnerable to diabetes and have poorer diabetes management compared to their urban counterparts (PriceWaterhouseCoopers, 2001). In Australia, the rural indigenous communities face substantial health disadvantage. Illness and mortality rate have been found to be directly proportional to the distance the major cities (Wakerman, Humphreys, Wells, Kuipers, Entwistle, & Jones, 2008). People living in remote areas have higher chances of contracting diabetes due to reduced access to primary health care services which results in poor health status (Azzopardi, Brown, Zimmet, Fahy, Dent, Kelly, & Wren, 20120. In many occasions, the remote and rural isolated communities are not big enough to support the traditional models of health delivery which makes them to rely on the urban healthcare which is often restricted by the isolation. The inability to access quality health services whenever a need arises often result in health needs not being adequately met, lack of continuity of care and poor health outcomes (Wakerman et al., 2008). Among Indigenous Australians, geographic disadvantage put them in an isolated environment, results in lack of accessibility to health services for normal health checkups and diabetes control programs, also less chance to get updated diabetes educations regard self-management issues throughout their disease process (Allen, Brown, Duff, Nesbitt & Hepner, 2013). Furthermore, According to Krass, Hebing, Mitchell, Hughes, Peterson, Song, and Armour (2011), the genetic issues put the Aboriginal in a different situation than the non-indigenous Australians BAU states that Indigenous Australians are more than three times as likely to report diabetes as non-Indigenous Australians. The metabolism of the Aboriginal Australians had been engineered by nature to make them efficient hunters and gatherers and survive with scarce food (Krass et al, 2011). Now when these aboriginal groups are exposed to modern lifestyle that is characterized by food and drinks that are rich in sugar and fats, alcohol and cigarettes, their once efficient metabolism is overwhelmed. As a result, the genetic make- up that enabled Aboriginal people to survive when food was scarce may now be a big disadvantage. Studies have shown that indigenous Australians living a modern lifestyle have high rates of obesity, impaired glucose tolerance; high blood pressure, high levels of fats in the blood and excessively high insulin levels in the blood, which all make them vulnerable to manage and control diabetes (Carey, 2013). In addition, elders in the rural community are the once who often face stiff challenges in diabetes management. The Aboriginal persons especially over 35 years are at a higher risk of contracting type 2 diabetes as compared to the non-indigenous (Meadows, 2009). The elderly indigenous Australians usually have a difficulty in adjusting their lifestyle due to the physical limitations. Cultural beliefs of the elderly community members can also be attributed to be a major contributor in terms of their self-identification, poor understanding of their health c challenges, low levels of motivation and urgency to seek health assistance as well as a challenge when adapting to westernized Diabetes Management Systems (Drevdahl, 2013). This makes in hard for them to manage diabetes and accelerate the process of the disease faster. Therefore, in the current Australian health care system, majority of the Aboriginal and other indigenous people are forced by circumstances to use the main stream health services that are hard to access, ineffective, culturally insensitive and inappropriate to their special health needs. 2. The poor ability of diabetes management has been attributed to poor health literacy. The health literacy concept which was originally defined as numeracy, reading and writing skills in health domain has significantly changed over the past 25 years and is now considered as a multidimensional concept (Vass, Mitchell, & Dhurrkay, 2011). According to the world health organization, health literacy refers to the social skills as well as the cognitive techniques which determines the ability and motivation of individuals to access, understand and effectively use information in ways that are perceived to promote and maintain significantly good health (WHO, 1998). Generally, health literacy requires that every individual have ability and will to gain insight to his or her health status and clearly understand the impacts of the social determinants on their health status and be able to effectively seek health care services at early stages when the disease is still preventable. These skills will eventually lead to personal empowerment and thus greater autonomy which results in behaviour and sound decisions that enhance general health. Therefore, poor health literacy is not just led by knowledge deficit of the condition alone, but also by multidimensional social determinants. 3. Health literacy among the aboriginal and the Torres Strait Islander is severely impaired due to various social determinants that affect their ability to gain insight about diabetes, skills of diabetes management and accessibility to health services. Indigenous people especially those in rural and remote areas are often associated with lower levels of education (Dick & Calma, 2007), which results in poor health literacy end eventually interfere with their capacity to use available health information regard health care (Durey, Wynaden, Thompson, Davidson, Bessarab, & Katzenellenbogen, 2012). In addition, government policies and health services are poorly engaged to rural Indigenous peoples. Inequality in health status experienced by Aboriginal and Torres Strait Islander peoples compares to the mainstream society. These shows in indigenous people have limited access to the mainstream services including primary health care and infrastructure (WHO, 2005). Also the aboriginal are relatively socioeconomically disadvantaged and this places them at a higher risk to exposure to environmental and behavioural health risk factors (Dick & Calma, 2007). Financial difficulties experience by the indigenous Australians is another factor that affects their accessibility to health care services, poor diet, and inability to purchase medicine which leads to poor diabetes management (Dick & Calma, 2007); Overcrowded and run-down housing is associated with poverty and contributes to the spread of communicable disease, which could accelerate the process of diseases such as developed skin infections associated with diabetes patient (Australian Human Rights Commission, 2005);excessive drinking and heavy smoking associated with lower socio-economic status which plays a crucial role in diabetes development and management (Dick & Calma, 2007). As a result, both disadvantages that are living rural, being Indigenous and being elders; and those social determinants accelerate their health concerns. Apart from these barriers to health, issues related to culture such as self-determination can also impact the health literacy of the aboriginal. According to world health organization, the exclusive right of self-determination includes but not limited to right for people to dispose their natural resources and wealth freely. Additionally, this greatly impacts the indigenous people given that both the native and communally owned land title deeds has always been an issue in Australia. This is attributed to the fact that land is highly regarded in Australia as a ‘natural wealth and resource’. Indigenous communities for a long time have lived a life they don’t value which has greatly contributed to their low motivation and participation, low self-determination, poor understanding of their health status as well as their ability to control it (WHO, 2005). This generally results to lower self-empowerment, ill health, poor management of chronic illnesses, as well as poor health issues engagement. Consequently, health literacy amongst Aboriginal people is severely impaired is due to social determinants, such as mental or emotional wellbeing, lower educational levels, poverty, and cultural perspective, that prevent them from gaining insight of the disease and diabetes management (Sorensen, Fowler, Nash, & Bacon, 2010). , Health literacy can be seen as a crucial outcome of health promotion. Accordingly, health literacy is a key asset since it allows individual to play active roles in communication and health education which results in development of competencies in the respective areas (Syurina, Brankovic, Probst-Hensch, & Brand, 2011). In addition, it is a method through which the indigenous elders would gain the ability to exert a greater degree of control over the environmental and social determinants of their health. According to WHO, health is not only lack of infirmity of diseases but comprises of complete state of mental, physical and social wellbeing (Carey, 2013). Primary health care views inequalities in health status are the result of social inequities. Diabetes can thus be prevented through the health promotion principles which include creating supportive environments, building health related public related policy, strengthening community action, reorienting health services and developing personal skills. Therefore according to the principles of primary health care, community nurse can moves the focus from illness and treatment to sustainable wellbeing, by focus on the empowerment of the individual, as well as with the strengthening of broad public policies and environmental influences, group and family participation and the community development (Victoria Government Information, n.d). These principles help community nurse to understand to focus on both individual needs of the aboriginals and the health determinants of the group as well (Lundy & Janes, 2009). 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